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This study was designed to develop an estimate of the percentage of cancer survivors with poor mental and physical health-related quality of life compared with adults without cancer.

The study found that poor physical and mental health quality of life were reported significantly more often by cancer survivors than by adults without cancer.

Cancer survivors may be cured of their disease, but they are still more likely to report a poorer quality of physical and mental health than adults who have not had cancer, researchers found.

In a national survey on health-related quality of life, 24.5% of cancer survivors reported poor physical quality of life and 10.2% said they had poor mental quality of life, according to Kathryn Weaver, PhD, of Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues.

That compared with 10.2% and 5.9%, respectively, among adults with no history of cancer, a significant difference (P<0.0001), they wrote online in the journal Cancer Epidemiology, Biomarkers, & Prevention.

They added that survivors generally "report more functional impairment, poorer health, greater psychologic distress, and more mental health needs" based on prior research.

The authors compared the prevalence of poor health-related quality of life in 1,822 cancer survivors with 24,804 adults who did not have a history of cancer through the 2010 National Health Interview Survey, an annual, in-person, national survey that "tracks trends in illness and disability in the U.S." and oversamples blacks, Hispanics, and Asians.

The survey recorded data on sociodemographic characteristics, as well as self-reported cancer history -- including site of cancer and age at diagnosis -- and additional comorbid health conditions. Survivors were also asked about current treatment status, types of treatments received for their most recent cancer, and cancer recurrence.

Quality of life was measured through the 10-item Patient-Reported Outcomes Measurement Information System Global Health Scale, which included outcomes on pain, fatigue, mental health, physical health, social health, and overall health. Survivor mean scores were evaluated against cancer-free adults' mean scores.

The researchers also compared quality of life for breast cancer survivors against quality of life for survivors of other cancers, because of the large amount of research surrounding quality of life among breast cancer survivors.

The rates of poor health-related quality of life translated to 3.3 million survivors with poor physical quality of life and 1.4 million survivors with poor mental health.

They also noted that "adult cancer survivors were older, less likely to be racial and ethnic minorities, more likely to be female, reported higher incomes, and had more noncancer comorbidities than adults without a history of cancer" and that nearly "12% of the survivors reported that they had a recurrence of their cancer."

Compared with adults who did not have cancer, patients who survived cervical, colorectal, hematological, short-survival, and other tumor site cancers had significantly worse quality-of-life scores (P<0.05). However, prostate cancer survivors reported significantly higher quality-of-life scores than cancer-free adults (P<0.05).

The effect of cancer site and time since last cancer diagnosis was statistically associated with all quality-of-life outcomes (P≤0.03), except for a trend between time since most recent cancer diagnosis and mental quality of life (P=0.07) and a lack of significant association between time since last diagnosis and satisfaction with social roles (P=0.25).

Only survivors of cancers with short survival had worse odds of a positive mental health score than breast cancer survivors (OR 4.63, 95% CI 1.83 to 11.70). Survivors of other cancers did not have significantly better or worse odds of positive mental health scores compared with breast cancer survivors.

"In general, we found that after adjustment for sociodemographic differences, long-term survivors of many of the most common cancers in the survivor population (breast, prostate, and melanoma) were doing as well or better than adults without a history of cancer," they concluded.

They added that "not all survivors report they are thriving," noting that nearly 5 million cancer survivors reported worse quality-of-life outcomes than average among adults who had not had cancer.

The authors found the study was limited by lack of recommended cutoff points for clinically significant impairments or minimally important differences in quality of life, treatment, and treatment-site influences on quality-of-life outcomes, self-reporting of life quality, and patient troubles with distinguishing between cancer recurrence and second cancers.

Cole Petrochko started his journalism career at MedPage Today in 2009, after graduating from New York University with B.A.s in Journalism and Psychology. When not writing for MedPage Today, he blogs about nerd culture, designs websites, and buys and sells collectible card game cards. He is based out of MedPage Today's Little Falls, N.J. Headquarters.

This survey is a poll of those who choose to participate and are, therefore, not valid statistical samples, but rather a snapshot of what your colleagues are thinking.

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